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"My approach to intervention is rooted in respect for child development and focuses on making the mundane meaningful, looking at daily interactions as opportunities for learning and growth while respecting the uniqueness of the individual and family. It’s about setting high expectations for long term quality of life and relationships for individuals on the spectrum and implementing a specific and doable plan to get there one step at a time.” – Lauren Wilson, LCSW, RDI® Program Certified Consultant

Tuesday, February 26, 2013

"How could he not know it?! We do it every single day! It's always the same."

And there in lies the clue. Always.

"It doesn't seem to matter, he never does it."

Ah, another clue. Never.

These situations of absolutes- always... never... tell us that we are operating above our child's competence. Kids (and adults) do well if they can. So if a child is never or always doing something in a situation... it means they're not there yet to meet our expectation. And that's ok. We can change and bring them up to it.

And this is important, because while failure can be a motivator for success... too much failure is a recipe for incompetence and a motivation depressant. And kids are very perceptive. They recognize when they are not meeting expectation.

So what can we do? We can close the gap.

Sometimes closing the gap means nixing what we're asking/expecting... for now. Sometimes it means changing the environment or how we ask so that your child can experience success.

Here are a few examples-

Never comes or responds when spoken to from a different room.

What can we change? Where we ask from! No sense in continuing to ask for a response from a different room when he never responds. Not only can it be very frustrating to the adult, it's also a failed scenario for the child. Find the distance... and modality that the child can be successful from. Start there and then begin moving farther away.

Always has difficulty following his nigh time routine.

What can we change? How much responsibility the child has for the routine. What's needed from us for the child to start having more successes? A visual check list? Us to sing a song during the routine? A change of routine?

As the ratio begins to change at the child has more successes you can increase the complexity and expectations and build upon those successes. It's a win win for everyone.

What are the Always/Never scenarios in your home? What could be changed so that everyone could have more success?

Tuesday, February 19, 2013

I got a call from an old colleague the other day asking about a student who couldn't read. Along the course of the conversation she mentioned that the student couldn't really sit still or attend.

Stop. Hold the presses.

One of the great challenges individuals with extra special needs present to us is knowing where to begin. We can feel such pressure when an individual is "behind" peers. That we sometimes start where the peers are- they are tying shoes... ok student with special needs must tie shoes too. They are reading in groups, student with special needs must read in groups. It makes great sense... at the same time where we need to start, is where the student is. This doesn't mean we stop setting goals far in advance of where the student currently is... but it does mean that we invest in the steps to get there.

I think of this great quote often, "If you have built castles in the air, your work need not be lost; that is where they should be. Now put the foundations under them." -Henry David Thoreau.

We need to dream big dreams for our children, and we need to spend equal amounts of time considering the small foundational, irreplaceable steps to get there. And while it may seem that we loose time by doing this in my experience we gain it.

What if we were to spend all our energy creating a reading program for a student who couldn't attend to a person? We would have a beautiful reading program that completely missed the step the student needed to benefit from it.

So Tuesday Tool Box- be a detective for the small steps that may be missing and required to reach a goal. Often even the simplest goal is much more complex to attain that we may give it credit for.

Tuesday, February 12, 2013

Being an effective guide is 95% mindset and 5% what you actually do. Our mindset and point of view are the roots from which all decisions are made. When I’m given a mere hour or half day to try to explain in a meaningful and practical way what RDI is, I focus on a simple phrase that encompasses a guiding mindset.

“Spotlight the Problem, Not the Solution”

Guides recognize that learning, and from there competence, comes with doing. It comes with struggling, thinking, failing and succeeding. Guides recognize their ability to make the most of regular ole’ interactions when they focus on spotlighting problems rather than solutions.

Bear with me during this illustration. Consider the following two phrases. Imagine them being said to you.

“Pick it up and put it here.”

“This is hard to figure out!”

This is kind of hokey, but literally feel your brain working as each is said. “Pick it up and put it here.” What’s your brain doing? Right, not too much; it’s pretty much basic compliance. A great skill to have no doubt, yet as a guide we know how limiting this can be for real world application.

Consider the relationship that would grow out of the two phrases. One could perhaps be characterized by a director and actor, ever in need of direction. The other guiding.

Here are a few more examples. Notice how the focus changes from the solution tothe problem and the effect it has on the relationship and what learning and opportunities will happen next.

“Say Hi Daddy”

“There’s Daddy!”

“Pick it up.”

“Oh no!”

“Sit down.”

“Circle time.”

“Try again.”

“This is just not working.”

“Good job!”

“We’re doing it!”

Providing solutions rob individuals of the chance to make those dynamicproblem solving connections that we so want them to have. Providing solutions can also give a false sense of the true abilities of an individual.

No where was this more evident to me than during an observation of a first grader. It was reported to me that he could independently manage classroom routines and a paraprofessional was probably no longer necessary. In a 3 minute period of my observation I counted how many solutions he was given. I could barely keep up withthe tallies. In three minutes he was given over 40 solutions. “Write your name.” “Erase, you need capitals.” “Push in your chair.” “Go to carpet.” “Cross your legs.” “Raise your hand.” And on and on and on. Many were given within a second of other children performing the action and often repeated more than once. I cringe just remembering, and acknowledging that I was once that solution focused voice on quick repeat.

I offered the paraprofessional a much needed break and sat back and truly observed. The class moved along and he sat falling farther and farther behind. He had no ownership over any of the learning that had been taking place. He had been complying on auto pilot failing to take note of his role in his own actions. Solutions had been given and therefore his dynamic problem solving abilities remained stagnant.

“Spotlight the problem, not the solution.”

After modeling, practice, adjusting work load and figuring out what his unique processing time was, we put this mindset into practice. The goal was no longer for him move along, it was to see his wheels turning; to see him practice dynamic thinking. And think he did.

This change in mindset is big and it is hard to do. When we see someone struggling for a solution our mirror neurons (http://video.pbs.org/video/1615173073) fire rapidly. We literally feel them struggling and are pulled to relieve that tension by providing a solution. And then, seemingly overnight it becomes an automatic response. Before we know it we’re anticipating the problem and providing thesolution before the child even recognizes it. We become the solution managers instead of the opportunity givers, decreasing rather than increasing our child’s ability to function in the world. We wind up doing all the dynamic thinking work for our children who need the most practice at it.

We know that change in possible, and it starts with us, the guides providing an environment where dynamic thinking can thrive. Start by taking time to do… well, nothing. Slow down. Observe your child, you’re looking for their edge of competence and that’s a moving target. What I find most often is that folks are surprised by what problems their child can solve on their own. What competence building moments for our children!

Opportunities (problems) will start to arise. Shoes will be lost. Zippers will get stuck. Play ideas will make one person happy and not the other. Your turn will be skipped. As you slow down you’ll see your child resolve many of them leaving you an opportunity to spotlight their competence. Others will loom larger and you’ll see the solution and want to blurt it out immediately.

Hold that thought.

It’s in this moment that your child needs you to guide them. To scaffold, what you see so clearly. Clarify the “problem” for them; guide them in the right direction. You might have to do this more than once. That’s ok. What’s important is you leave that room, no matter how small, for your child to discover the solution. And who knows, it might be better than the one you had in mind! :)

“Spotlight the problem, not the solution.”

Here are a few more examples to consider

Child takes your turn while playing

Give “the look” and smile

It is taking longer than expected and you can see it on your child’s face

Wednesday, February 6, 2013

There is so much interesting and excellent research on Autism out there, and while I love a wonderful article to read, there is also something to be said for one already nicely summarized for you. Especially many here:Recent Autism Research that are compiled from the National Institute of Mental Health. I'm especially thankful for the comprehensive and comprehendible summary of genetic research- those medical journals can be wordy- not on this site- easily understood.

Tuesday, February 5, 2013

You are what you eat... you're also what you think. Earlier this week I posted an interesting video portrayal of the power of thought- and how what we actually think effects our neurology. Fascinating stuff.

It's the basis for much of Cognitive Behavior Therapy which recognizes that what we think about ourselves, our environment and relationships can impact our interactions with them. So changing our narrative changes our behavior and perceptions as well. Consider the individual on the spectrum (or anyone for that matter) who has an internal narrative "I am not good at anything. I can not do it." This can be common for individuals who so frequently engage in black and white thinking, or all or nothing thinking. Sometimes linked to one negative experience in a sea of otherwise positive or neutral experiences.

What would the likelihood be that the individual would ever want to try anything new? Slim to none! Changing that internal narrative can have an immense impact on a person's ability to navigate the world.

Interesting is a blog post about Cognitive Behavioral Therapy with individuals on the spectrum, complete with research findings.

Monday, February 4, 2013

You can write the script before you even ask the question... which begs the question... why ask it?

You're asking with the goal of connecting... and you're getting anything but... so let's change it up.

Einstein has a great quote-
“Insanity is doing the same thing, over and over again, but expecting different results.” How often we find ourselves in this situation!?
So what can we do?

First let's examine our goal. Most frequently our goal is to connect, share experiences with our kiddo. We aren't actually looking for a detailed accounting of the day. We want to see the world through their eyes. We care about them and want to know what life was like today. What we recognize for our goal is very important because it dictates how we adjust ourselves and what we determine is success.
With a goal in mind, we can start to think about what we can adjust to make it happen.

"How was school today?" "What did you do today?" Clearly not working. Let's examine why it might not be working. First know that even among neurotypical children- it's not a well liked or answered question. In thinking about why it's not working we need to ask ourselves - Is it developmentally appropriate? Can my kiddo typically answer such broad questions? These may sound simple- they're not. Often even the easiest of social scenarios is much more complex than meets the eye. To answer a question assumes that you're able to shift your internal focus to mine just by me talking to you. A huge feat!

We might also have to think about the timing. Sometimes it can make all the difference. Being asked right when the kiddo is picked up or jumps in the car, walks in the house can feel like a barrage more than a time to connect. So often less is more. Maybe one day you try not saying anything and see how your child naturally navigates the school -> home transition and when they seem fully transitioned from one activity to another.

So what would happen if we changed it up? What if instead of flat out asking, "How was school today?" We started a little more concrete. You might rifle through the backpack to find some piece of school work that was sent home, bring it to the child and say, "Wow!" or "Math facts again!?" "Pretty!" "You love spelling." Or you point to the big grass stain on the pants and say "Recess was messy!" By having something tangible to look at together we're bringing our goal of connection to a level our child can be successful. We're also tapping into their visual memory which might be stronger. It's much easier to remember something you can see than to brainstorm on the spot. Think of how much more you remember and can talk about when showing pictures of your vacation as opposed to just being asked cold, "What did you do on your vacation?"

In the same vein of providing a clearer map for the recall by using visual memory you might also try purposefully mis-guessing about the day. "It's Tuesday- you saw Ms. Smith." Especially if you know you're child knows that they only see Ms. Smith on Wednesdays. This again brings things down to the concrete level and now you've got a conversation starter. Chances are they might correct you.. and you've got an in.

Now you've got some true opportunities for novel connections instead of the same ol' same ol'. Not everything will go as planned- that's ok. Anything is better than hearing the dreaded... "fine."

And here's the annoying yet very true disclaimer- each kiddo is unique- take the tools and adjust them for your particular needs. :)

Senate Bill 668 was passed with amendments (not posted yet what they are) out of committee and now the sister bill House Bill 721 is up for hearing in front of the Committee on Consumer Protection & Commerce on Wednesday February 6, 2:30pm House Conference Room 325.

I encourage you to share your voice with your representatives and through written testimony (in person available to Oahu residents able to brave the traffic). Submitting testimony online is actually quite easy. You can either upload your own document or simple click "comments only" and type in your comments.

The bill would mandate insurance provide coverage up to $50,000 per year for Autism Treatment. While the language today is broad there is always the possibility it can be amended to box families in to particular types of treatments limiting freedom of choice (see page 5, lines 3-7). It would further be encouraging if line 5 read, "including but not limited to applied behavior analysis". For no other population do we see legislators taking freedom of treatment choices from a parent, individual or licensed experienced professional. Every individual is unique and their treatment protocol should reflect thei unique needs.

Families and individuals deserve the trust and the right to pursue what is best for them.

It is so exciting that Hawai'i may join the many states that mandates insurance coverage for autism treatment. I am hopeful it will continue to respect the individual needs of persons on the spectrum and their families to work with professionals and pursue whichever evidenced based practices suit their needs.

Best,

Lauren Wilson

Testimony may be submitted until Tuesday February 5, 2:30pm to be available and considered before the hearing. Late testimony may also be submitted after 2/5.

Saturday, February 2, 2013

It's taking a bit for me to connect all the ways the examples in the video relate to guided participation- and individuals on the spectrum. One of the first things that popped in my mind, was appraisal... and how the fast brain in all of us makes quick appraisals of situations... and how so often for individuals on the spectrum this appraisal is off and based on a non-essential element of the situation or relationship at hand. Very interesting, I will be thinking about this more.

I found myself thinking about individuals on the spectrum who sometimes display rather static imagination, while their neurotypical counter parts display dynamic/ever changing imaginary play. The leap I considered was if just the "imagination" of these scenarios changes neural connections... that so too would the static strengthen static connections.

Quite humbling exactly how pervasive a spectrum disorder is... and on the flip side how absolutely complex our neurology is.